A biased look at psychology in the world

Neuropsychology

December 07, 2016

Have you ever had a "senior moment" when your memory fails unexpectedly? Though it can happen at any age, it can often be an uncomfortable reminder that you are getting older.

Long recognized as an inevitable part of the aging process, most seniors tend to laugh these lapses off. Still, a slow decline in mental and physical functioning can seriously compromise quality of life, especially if it leads to neurodegenerative conditions such as Alzheimer's disease. And this is a problem that affects everybody. As the Baby Boom generation grows older, we are seeing a rapid growth in the number of seniors worldwide. By 2050, the number of adults over the age of 65 is expected to outnumber children by two to one. Though advances in geriatric care, improved public health measures, and rising standards of living are allowing people to live longer and more productively, the health care systems in most countries are already falling behind in the services available for many seniors, especially seniors suffering from dementia.

As part of a worldwide research initiative, geriatric researchers have been studying how the brain changes with age and how to prevent the devastating loss of cognitive functioning seen in many seniors. But, in studying how memory and cognition can decline in seniors, it is important to recognize that not all cognitive abilities will decline at the same rate. Working memory, usually defined as the ability to hold, process, and manipulate information on a short-term basis, seems especially vulnerable to aging (particularly after the seventh decade of life). Then there is long-term episodic memory or the recall of autobiographical information which can also be affected by aging.

Brain imaging research has shown that aging produces key changes in the brain including the thinning of gray matter in the cortex, decreased density of white matter fibres, expanding ventricles, depletion of essential neurotransmitters, and changes in brain networks. Some regions of the brain seem to be more affected than others however and, not surprisingly, those regions of the brain linked to working memory seem to show the greatest changes due to age. These include the dorsolateral prefrontal cortex, the superior parietal lobe, and the medial temporal lobe, all of which play a critical role in the encoding, storage, and retrieval of memories.

Along with the slow loss of cognitive functioning linked to aging, the aging brain can also become much more vulnerable to injury or disease. Concussions or other forms of brain damage can affect cognitive functioning at any age but younger brains can usually recover due to neuroplasticity. In older adults, this kind of brain damage can be much more serious and can often act as triggers for the development of dementias such as Alzheimer's disease or vascular dementia.

December 02, 2016

It all began with a daily meeting at a newspaper in Moscow, sometime in the 1920s.

The editor was handing out assignments to the various reporters and was annoyed to note that one of the newer reporters had neglected to bring along a notebook. Solomon Shereshevsky (sometimes spelled Sherashevsky), then 29 years old, was quietly listening to the editor speak while all of his fellow reporters were busy writing down their assignments. The editor had noticed this before and decided to give his employee a scolding for not paying proper attention. When meeting him afterwards, the editor was astonished to find that Shereshevsky was able to remember every detail of the meeting with perfect accuracy. The journalist was just as astonished at his editor's reaction since he thought his perfect memory was normal. Always on the lookout for an interesting story, the editor decided to send his reporter to the local university for testing. It was there that Solomon Shereshevsky met neuropsychologist Alexander Romanovitch Luria and an amazing collaboration began.

Over the course of the next 30 years, Luria would carry out an extensive series of experiments examining the journalist who would become his most famous case. Solomon Veniaminovitch Shereshevsky (identified only as "S" in Luria's writings) was born in Latvia and was part of an accomplished family (his father was a bookstore owner who could recall the location of every book in the store while his mother knew much of the Torah by heart). Although he had originally trained as a violinist, Shereshevsky became a journalist after an ear infection ended his musical career. Given his perfect recall, conventional memory testing was impossible but Luria was able to detail the processes underlying how Shereshevsky was able to memorize details so accurately. During the research trials, Shereshevsky was able to recall extensive lists of words, numbers and even nonsense syllables without mistakes and with only occasional hesitation. He could also report the numbers or letters in reverse order and could retain the information, seemingly indefinitely. Even events from early childhood could be recalled (including things that happened when he was still in his crib). There also appeared to be no limit to his digit span (as opposed to the seven to nine items that most humans can manage).

Based on his research, Luria concluded that Shereshevsky possessed an extreme form of synaesthesia which he used to convert various stimuli into visual images. It was this visual imagery that was one of the key factors in his astonishing recall. Whatever he was asked to remember, he would first mentally convert into visual images but often needed extra time to make the conversion. The perfect recall only failed when this process was disrupted in any way. He was even able to convert music and numbers into visual imagery by imagining the tones or numbers visually.

There were some intriguing limits to what Shereshevsky could remember however. He had a surprisingly poor memory for faces or voices heard over a telephone. He also had difficulty with abstract logical concepts and metaphors and often appeared slow and forgetful to others meeting him. His synaesthesia made him acutely sensitive to changes in his environment (for him to enjoy food in a restaurant, there had to be the right kind of background music playing).

As for Solomon Shereshevshy? His amazing memory was also a serious handicap since his visual imaging meant that he frequently spent his life in a nonstop daydream. He gave up his journalism career and became a professional mnemonist giving regular shows to paying audiences. Despite his success, he never had great satisfaction as a performer and gave it up after a while. The last reference that I could find on him was that he became a taxi driver in Moscow but his life faded into obscurity afterward. Aside from a possible death date in 1958, there seems to be little else available.

By his own reckoning, Shereshevsky viewed himself as a failure in life since he was unable to use his vast memory in a way that he found personally fulfilling. He had wanted to be remembered for accomplishing something "great" in his life and, given his place in the history of psychology, may have succeeded. In 1998, Peter Brook released a theatre production based on Shereshevsky titled Je Suis Un Phenomene (I am a Phenomenon). Solomon Shereshevsky will be remembered.

October 25, 2016

Auditory hallucinations, i.e., hearing sounds or voices without external input, are often scary, both for the ones with the hallucinations and the people around them. Though these kind of hallucinations were treated with awe and dread in ancient times, more recent cases have typically been viewed as symptoms of mental illness and treated by medical doctors. Along with Joan of Arc, Socrates, and Pythagoras, other famous examples include Galileo who reportedly heard the voice of his dead daughter while grieving over her death and Robert Schumann who suffered from increasingly complex musical hallucinations (including angelic and demonic choirs).

An estimated five percent or less of the general population has reported hearing voices though rarely on a regular basis. While most commonly seen in cases of severe mental illness, they can also occur in people of all ages and all walks of life. Though mental health professionals continue to grapple with the complex issues surrounding auditory hallucinations, new research suggests that people can learn to live with them and even thrive. In a recent TED talk by psychosis patient Eleanor Longhorn, she described her history of coping with psychiatric treatment and suggests that learning to listen to the voices in her head helped her survive and move on with her life.

A new article published in Schizophrenia Bulletin presents the results of an innovative study suggesting that auditory hallucinations may be far more common than we realize and, in many cases, can be experienced by people who view them in positive ways that don't require psychiatric treatment. Conducted by Alfred Russell Powers III and Philip R. Corlett of the Yale School of Medicine, the study compared voice hearers with a diagnosable disorder such as schizophrenia with self-proclaimed psychics who often reported hearing voices as well.

In an interview with Medscape Medical News, Dr. Powers said that the voices reported by psychics are often reported as clairaudient experiences which are regarded as positive and even protective. As Dr. Powers pointed out, "Some of my patients are pretty traumatized by auditory hallucinations, and we are pretty limited in the options we can offer them for treatment if they fail that first line. One of the reasons for that is that we don't really understand how hallucinations arise in the brain...For that purpose, it would be really useful to have a population that doesn't have medications, that functions quite well and does not have the full spectrum of psychotic disorders but does, nonetheless, have auditory hallucinations."

His co-author, Dr. Corlett, added that "There's been indications that one could use cognitive-behavioral therapy in particular to teach people hearing voices not to completely ignore them or push them down but to learn to live with them and to work around them. We think that perhaps the people in our psychic group might have learned to do that on their own, and may be more capable than patients with schizophrenia to do that on their own....By comparing the psychics to the schizophrenia group, we think we may be able to learn more about how they do it. Ultimately, we'd like to try to teach patients how to do that or come up with new interventions that we can use to help patients come to that conclusion as well."

September 08, 2016

A major area of unmet need is the development of strategies to restore neuronal network systems and to recover brain function in patients with neurological disease. The use of cell-based therapies remains an attractive approach, but its application has been challenging due to the lack of suitable cell sources, ethical concerns, and immune-mediated tissue rejection. In a recent article published in BMC Neuroscience, researchers propose an innovative approach that utilizes gut-derived neural tissue for cell-based therapies following focal or diffuse central nervous system injury. Results showed that enteric neuronal stem and progenitor cells, able to differentiate into neuronal and glial lineages, were isolated from the postnatal enteric nervous system and propagated in vitro. Gut-derived neural progenitors, genetically engineered to express fluorescent proteins, were transplanted into the injured brain of adult mice. Using different models of brain injury in combination with either local or systemic cell delivery, the researchers showed that transplanted enteric neuronal progenitor cells survive, proliferate, and differentiate into neuronal and glial lineages in vivo. Moreover, transplanted cells migrate extensively along neuronal pathways and appear to modulate the local microenvironment to stimulate endogenous neurogenesis. These findings suggest that enteric nervous system derived cells represent a potential source for tissue regeneration in the central nervous system. Further studies are needed to validate these findings and to explore whether autologous gut-derived cell transplantation into the injured brain can result in functional neurologic recovery.

August 23, 2016

While the potential role of the Zika virus on brain development in fetuses has raised fears among pregnant mothers worldwide, new research suggests certain adult brain cells may be vulnerable as well. A team of researchers at the Rockefeller University and La Jolla Institute for Allergy and Immunology has found that the Zika virus targets neural progenitor cells leading to loss of the brain's ability to form neurons. In developing infants, this can result in microcephaly leading to smaller than normal heads and numerous developmental disabilities.

Adult brains have previously been assumed to be less susceptible to the Zika virus due to being fully developed though the researchers have found this isn't necessarily the case. Even in mature brains, certain niches exist containing neural progenitor cells. Believed to be vital in learning and memory, lead researcher Joseph Gleeson, an adjunct professor at Rockefeller University, and his co-researchers used fluorescent biomarkers to demonstrate that adult neuroprogenitor cells could be infected by the virus as well.

"Our results are pretty dramatic -- in the parts of the brain that lit up, it was like a Christmas tree," says Gleeson in a press statement released by Rockefeller University. "It was very clear that the virus wasn't affecting the whole brain evenly, like people are seeing in the fetus. In the adult, it's only these two populations that are very specific to the stem cells that are affected by virus. These cells are special, and somehow very susceptible to the infection."

Healthy adults are usually able to fight off infection but people with compromised immune systems may be vulnerable. New neurons formed by neural progenitor cells are vital in neuroplasticity which allows the brain to change over time. “In more subtle cases, the virus could theoretically impact long-term memory or risk of depression,” says Gleeson, “but tools do not exist to test the long-term effects of Zika on adult stem cell populations.” Zika may also be linked to Gullain-Barre syndrome in which the immune system attacks parts of the nervous symptom leading to loss of motor functioning and paralysis in many cases. Though the cause remains unclear, Gleeson and his colleagues suggest that the disease can occur due to Zika attacking neuronal progenitor cells in the brain.

While more research is still needed to measure the subtle effects that Zika can have on adult brain functioning, the public health risks are alarming. Already widespread in Central and South America, the Zika virus seems poised to spread worldwide. “The virus seems to be traveling quite a bit as people move around the world,” says Gleeson. “Given this study, I think the public health enterprise should consider monitoring for Zika infections in all groups, not just pregnant women.”

July 15, 2016

Born George Wild Galvin in 1860, he was the youngest of six children in an old London show business family. His father was a comedian and his mother was a singer and George soon showed that he had inherited both talents. He made his debut as "Little George,the Infant Wonder" when he was only four years old and quickly became a regular part of the family act. After their father died, George and his brother, Henry later began touring as The Brothers Leno-Champion Dancers (Leno was their step-father's name) and toured across the United Kingdom before George went solo in his late teens.

He was never a tall man (he barely reached five feet in height) but made up for it with his dancing skills, his comic wit, and his sparkling delivery. He quickly became known as the "Funniest Man on Earth" with an astonishing range of talents. He performed comic skits, danced, sang funny songs and generally had the audience in stitches with his antics. Despite his grueling schedule and daily performances, he still somehow managed to find time to marry and have six children over the years. By the 1880s, he was Great Britain's top-billing music hall star and regularly performed to sold-out audiences at London's Drury Lane. At the height of his popularity, Dan Leno was entertaining Queen Victoria and, later, King Edward VII (which earned him the nickname of the "King's Jester").

And then...

In 1902, Dan Leno suffered what was later termed a "nervous breakdown". His behaviour became increasingly erratic and he also became hard of hearing. Leno's family was alarmed by his odd behaviour and strange delusions (he began proclaiming that he was descended from a Scottish marquis). He also became more grandiose and announced that he was giving up comedy for a career as a serious actor.

On one occasion, Constance Collier, a prominent Shakespearean actress, came home at 1:00 AM to find Leno waiting for her outside her home. He told her that he wanted to play Hamlet and urged her to use her influence to get him the part. Like most of London, Collier was one of Leno's fans but she could see that he was acting strangely. She was able to get him to leave by promising to talk to a director friend of hers but Leno was back the next night with an expensive gift of jewelry. She finally refused his request firmly and Leno left brokenhearted (he gave the jewelry to a barmaid on his way home).

In 1903, he was sent to a nursing home in Camberwell where he still showed signs of the awesome comic talent that had made him famous. Despite an attempt at resuming his performances, Dan Leno died on October 31, 1904 at the age of 43. News of his death made international headlines and thousands of fans attended his funeral. He is buried in Lambeth Cemetery near the gardens that still bear his name.

The actual cause of Leno's death continues to be a matter of controversy. His death certificate lists "General Paresis of the Insane" (a common term for neurosyphilis) although there is no actual evidence that he ever had the disease. Another possibility that more recent historians have raised is that Leno died of a brain tumour. Unfortunately, the loss of hearing and behavioural symptoms that he showed during his decline do not provide enough information to make a clear diagnosis.

For all his popularity, most of the comic routines that he performed during his long career have been lost. While there are a few scratchy sound recordings that survive, what little is known of Leno's performances are taken from popular writers of the time such as Max Beerbohm. One of his sons, Sidney Leno, later toured as Dan Leno Junior but he never matched his father's success.

Despite being largely forgotten today, Dan Leno's influence on later comedians was profound. The great Stan Laurel viewed Leno as one of his heroes and based many of his own comedy routines on skits that Leno had first performed. Charlie Chaplin, Buster Keaton, and many of the other comic greats of the silent era were also influenced by Leno. That people are still laughing at antics inspired by Dan Leno more than a century after his passing may well be the best possible monument to a funny man who died far too soon.

July 12, 2016

Acetaminophen, a.k.a. paracetamol, is one of the most commonly-used over-the-counter remedies for pain and fever. First discovered in 1877, it has long been considered safe if used at recommended levels and is included on the World Health Organization's Model List of Essential Medicines. Long seen as harmless for pregnant women, acetaminophen has been used extensively to help alleviate pain and discomfort. But a new study published in the International Journal of Epidemiology raises serious concerns about the prenatal risks associated with acetaminophen, including the development of autism-spectrum disorders and hyperactivity. It is also one of the first studies showing different effects on boys and girls.

A team of Spanish researchers led by Claudia Avella-Garcia of Barcelona's Center for Research in Environmental Epidemiology (CREAL) examined 2644 mother-child pairs recruited during pregnancy. Follow-up assessments were conducted with 88 percent of the mother-child pairs when the children were one year old and 79.9 percent when they were five years old. Along with structured interviews for the mothers, the children were tested with a series of psychometric measures including the Childhood Autism Spectrum Test (CAST), Conner’s Kiddie Continuous Performance Test (K-CPT), and ADHD-DSM-IV form list.

In the structured interviews, mothers were questioned about their acetaminophen use during pregnancy. Since mothers could not recall exact doses taken, they were rated as either ever/never used acetaminophen and for those who reported use, being rated as sporadic or persistent use.

Results showed 43 percent of children at age one and 41 percent of children at age five had at least some exposure to acetaminophen while their mothers were pregnant. When assessed at age five, exposed children were found to be higher risks for developing hyperactivity or impulsivity symptoms. On tests measuring visual speed processing and inattention, exposed children score much more poorly than unexposed children. There are also significant gender differences with boys being more likely than girls to develop autism spectrum symptoms following prenatal exposure to acetaminophen. While the researchers focused on autism spectrum symptoms instead of whether children were formally diagnosed with autism, the range of symptoms linked to prenatal acetaminophen and the impact on the later development is disturbing.

When asked when acetaminophen could have an impact on brain development in children, co-author Dr. Jordi Júlvez, suggested in an interview: “Paracetamol could be harmful to neurodevelopment for several reasons. First of all, it relieves pain by acting on cannabinoid receptors in the brain. Since these receptors normally help determine how neurons mature and connect with one another, paracetamol could alter these important processes. It can also affect the development of the immune system, or be directly toxic to some fetuses that may not have the same capacity as an adult to metabolize this drug, or by creating oxidative stress.” Male brains my be more vulnerable to the effects of acetaminophen due to disruptions in male hormone production for which female brains would be much less likely to be affected.

Though the researchers stress that more studies are needed, they suggest that widespread exposure to acetaminophen, which continues to be used extensively during pregnancy, can lead to a surge in ADHD and autism-spectrum cases. Medical doctors and patients need to be more aware of potential risks and weight them against the benefits involved.

June 09, 2016

Optimal stimulation theory and moderate brain arousal (MBA) model hypothesize that extra-task stimulation (e.g. white noise) could improve cognitive functions of children with attention-deficit/hyperactivity disorder (ADHD). A new study published in the journal Behavioral and Brain Functions explores the benefits of white noise on attention and inhibition in children with and without ADHD (7–12 years old), both at behavioral and at neurophysiological levels. Thirty children with and without ADHD performed a visual cued Go/Nogo task in two conditions (white noise or no-noise exposure), in which behavioral and P300 (mean amplitudes) data were analyzed. Spontaneous eye-blink rates were also recorded and participants went through neuropsychological assessment. Two separate analyses were conducted with each child separately assigned into two groups (1) ADHD or typically developing children (TDC), and (2) noise beneficiaries or non-beneficiaries according to the observed performance during the experiment. This latest categorization, based on a new index the researchers called “Noise Benefits Index” (NBI), was proposed to determine a neuropsychological profile positively sensitive to noise. Results showed that noise exposure reduced omission rate in children with ADHD, who were no longer different from TDC. Eye-blink rate was higher in children with ADHD but was not modulated by white noise. NBI indicated a significant relationship between ADHD and noise benefit. Strong correlations were observed between noise benefit and neuropsychological weaknesses in vigilance and inhibition. Participants who benefited from noise had an increased Go P300 in the noise condition. The improvement of children with ADHD with white noise supports both optimal stimulation theory and MBA model. However, eye-blink rate results question the dopaminergic hypothesis in the latter. The NBI evidenced a profile positively sensitive to noise, related with ADHD, and associated with weaker cognitive control. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

But disturbing new revelations about health problems developed by members of that historic team have cast a dark shadow on the world of professional football. At least three former team members have been diagnosed with Alzheimer's disease believed to be related to the repeated concussions they sustained during their playing careers. These three members, Martin Peters, Nobby Stiles and Ray Wilson, are all experiencing early onset dementia with more likely to emerge in the near future.

And that may just be the tip of the iceberg. When former England and West Brom striker Jeff Astle died in 2002 of a degenerative brain disease, a verdict of death by industrial injury was given. Family and friends disputed the verdict due to suspicions that the illness may have been caused by the common practice of heading soccer balls during play. Though modern soccer balls are made of plastic, they were considerably heavier in Astle's day due to their leather construction. Despite research evidence showing the potential brain damage caused by this kind of repetitive damage, the Football Association dismissed allegations that Astle's soccer playing was involved. A "Justice for Jeff" campaign was later launched by outraged fans to put pressure on FIFA to acknowledge the dangers faced by professional players and the Astle family publicly referred to the lack of awareness as "sport's silent scandal."

It was only in 2014 that Professor Willy Stewart of Glasgow University examined Jeff Astle's brain and concluded that he had been suffering from Chronic Traumatic Encephalopathy (CTE) at the time of his death. Also known as dementia pugilistica, CTE is commonly found in boxers, wrestlers, and rugby players. Based on these findings and the growing publicity surrounding CTE in soccer players, FIFA launched a panel of distinguished experts to review playing rules and prevent further CTE cases. The panel included Willie Stewart as well as Professor Bob Cantu from Boston University, Professor Tony Belli from Birmingham University.

In discussing his work on the panel, Professor Stewart described the progress made to date in an interview with the Daily Mail. "The concussion panel has met once in the past year and drawn up some excellent guidelines for treating concussion but I am not aware of any progress in terms of research. In isolation, the 1966 team could be a statistical anomaly but when you start looking at groups of players from Hearts, Port Vale, Rangers, Bristol Rovers and more, all with significant numbers of former players suffering from dementia in their 50s and 60s, it is time to start asking serious questions."

Dawn Astle, daughter of Jeff Astle, and one of the organizers of the "Justice for Jeff" campaign, worries that FIFA and other sports organizations aren't moving quickly enough. "We’re finding clusters of players from the same teams all suffering from forms of early onset dementia," she said. "We’ve got players from the 1960s and 70s dying from it and probably 90 per cent are centre forwards, who headed the ball a lot. That’s more than coincidence. More than 250 people have been in touch with us, with either a dad or husband who has the condition or who died of degenerative brain disease. All of them believe repeated head injuries sustained playing football caused the illness.’"

April 08, 2016

It was in 1836 that a book was published in New York that seemed tailor-made to touch off a moral panic. Titled The Awful Disclosures of Maria Monk or The Hidden Secrets of a Nun's Life in a Convent Exposed, the purported author of the book, an ex-nun named Maria Monk provided lurid descriptions of her life in a Montreal convent and the sexual exploitation that she faced there.

According to the book, she and other nuns of the Sisters of Charity of the Hotel-Dieu (also known as "the Black Nuns"), were routinely sexually abused by the priests at a seminary next door. Using a secret tunnel that linked the convent to the seminary, priests would enter to have sex with the nuns on a regular basis. If children resulted from the sexual acts, the babies would be baptized and then "smothered or secretly buried in the cellar". Nuns who refused the sexual advances of priests would be murdered. Maria said that she had stayed in the convent for seven years before becoming pregnant by a priest. It was fear for her child's life that finally caused her to flee Canada and go to the United States for safety and to give birth to her child.

Certainly the time was right for such a book to be widely accepted. Due to the influx of Irish immigrants, there was considerable anti-Catholic sentiment in the United States during that period and dark rumours about Catholic clergy and their hidden vices were widespread. Two years before the Monk book came out, another "tell all" book about life in a convent published by ex-nun Rebecca Reed was filled with allegations of forced conversions and abuse. At the same time, a convent in Massachusetts had been burned to the ground by a mob following rumours of a former nun being held against her will there. The publication of Maria Monk's book fed into the hysteria nicely and generated a tremendous outcry with calls for the investigation of the convent by leading Protestants in New York and Montreal. An investigation launched by the Bishop of Montreal turned up nothing but was quickly dismissed as a cover-up. It would take a full-scale investigation by a New York newspaper named William Leete Stone leading a team of Protestants to the convent to determine that, not only was there no secret tunnel, but it was unlikely that Maria had ever been there at all

This opened the floodgates to claims and counterclaims. Maria's supporters accused the Church and the convent of secretly destroying all evidence that might have confirmed Maria's story. Her critics (and there were an increasing number of them), used the inconsistencies in her account to discredit her. According to later sources (including her mother), Maria had sustained brain damage at the age of seven after "ramming a slate pencil into her head". As a result, she was given to telling "whoppers" thereafter. Not only was she never a nun, she was not even Catholic and had a history of telling colourful tales of abuse to anyone who would listen.

Apparently, during the period when she had supposedly been in the convent, she had actually been incarcerated in a Magdelene asylum following an arrest for prostitution. As it turned out, it was her legal guardian (and lover), William Hoyt who had come up with most of the details that found their way into print (not to mention pocketing most of the profits from the book). Maria had actually contributed little to the book itself as it had been largely ghost-written by a local publisher. Despite the revelations, Maria would publish a sequel titled Further Disclosures which also sold well. She had left Hoyt by that time and had taken up with another "protector" who soon left her after pocketing most of the sequel's profits.

Following the birth of a second illegitimate child in 1838, her few remaining supporters abandoned her and Maria lived the last years of her life in alcoholic poverty. She died in a New York debtor's prison in 1849 after being arrested for picking the pocket of a man with whom she had been cohabiting. Despite her sad end, her book has gone in and out of print and many anti-Catholic sources still cite her revelations as true.

What to make of Maria Monk? While there is evidence that her childhood brain damage had left her with a case of pseudologia fantastica, she was also clearly exploited by the men in her life who cashed in on her tales and abandoned her when she stopped being of use to them. Does that make her a victim or not? You be the judge.